Apply to join Ken-ya Yoga? | A yoga and safari adventureApply to join Ken-ya Yoga? | A yoga and safari adventureIf you are human, leave this field blank.Select a date19 Jun - 2 Jul 2021 (Gena - Luxury Accom)23 Sep - 2 Oct 2021 (Nalini)27 Jan - 7 Feb 2022Yoga experienceNoneLimitedIntermediateAdvancedGender*MaleFemaleOtherPersonal details (as per passport)*First NameLast*Last NamePreferred*NicknamePassport number*Passport numberNationality*NationalityPlace of birth*Place of birthIssue date*Issue date (dd/mm/yyyy)Expiry date*Expiry date (dd/mm/yyyy)Date of birth*Date of birth (dd/mm/yyyy)Phone*PhoneEmail*EmailAddress*StreetSuburb*SuburbState*StateCountry*CountryPostcode*PostcodeTell us about you*We use this info to make sure this is the right adventure for you. If your application is successful, we also use the information to introduce you to the rest of the tour group. Things you could include: what you do, things you are passionate about, what you are most excited for during the tour, something interesting/unique about you, etc.Allergies, medical conditions or special requirements*Please advise us if you would like us to call you to discuss.Emergency Contact*First NameEmergency Contact*Last NamePhone*PhoneEmail*EmailDiscount codePlease enter your discount code if you have oneShirt size*X-SmallSmallMediumLargeX-Large4X-LargeComplimentary yoga or travel shirt.How did you hear about us*Friend or family memberYoga studioTravel agentSocial mediaGoogle searchOtherFlights*Yes (I need help booking)No (I will book my own flights and email my fight itinerary to info@adventureoutloud.me)Travel insurance*Yes (I need help booking)No (I will purchase my own policy and email a copy of my policy to info@adventureoutloud.me)I want to add: Gorilla trekking (5 days) Chimp trekking (5 days) Single supplement (yoga & safari) Single supplement (gorillas or chimps) Mt Kilimanjaro (10 days) Adventure memories travel bookSponsor a disadvantaged student through school* Yes NoSponsorship is not mandatory and we donate 50% of our profits to charity so you are already making a big difference just by travelling with us. We do appreciate when our adventurers go above and beyond and personally sponsor though. By doing this, you will empowering a young African student by keeping them in school. Sponsorship starts from AUD$15 - $20/week and 100% goes to our partner charity. Fundraising is also a great option.Payment options* 10% Deposit with subsequent weekly/fortnightly/monthly instalments 10% Deposit with subsequent instalments (25% at 180, 120 & 90 days before departure | remainder 60 days before departure) Full feeUpon receipt of your registration form, we will send you an invoice that includes payment options and directions for payment. Minimum deposit is 10% of total fee.I acknowledge that the information supplied on this registration form was supplied by me, is true and accurate and if under 18 years was provided in the presence of and with the approval of my parent/guardian. By paying my adventure deposit, I acknowledge that I have read Adventure Out Loud's Terms & Conditions and that I agree to be bound by these terms and conditions.* Agree Disagree (please contact me to discuss)Our Terms & Conditions can be found below.reCAPTCHASubmit